Outreach/Enrollment in New Health Insurance Exchanges

Outreach/Enrollment in New Health Insurance Exchanges

Monday, December 3, 2012

Enroll America

Under the Affordable Care Act, new Health Insurance Exchanges will open in 2014 and will serve as an access point for securing health insurance coverage in the individual and small group markets and through Medicaid. Health Centers and other HRSA-funded programs like Ryan White play a key role in conducting outreach and enrollment to help uninsured and under-insured individuals gain access to new coverage options. These two guides briefly touch upon many tasks and roles for safety net providers, such as:

Educating current and new patients about expanded coverage options (both Medicaid and individual/small group offerings).

Understanding state exchanges in terms of coverage options, enrollment and renewal processes, and being part of their outreach and engagement plans.

Training staff to conduct outreach, eligibility determinations, and enrollment and using varied methods to carry out these activities (e.g., developing outreach plans, using technology to target outreach, using data on current patients to enroll them in new coverage if eligible).

Understanding changing finances (e.g., impact of more patients with coverage under expanded Medicaid and individual/small group coverage, possible changes in finances as more patients are covered by Medicaid and insurance versus self-pay with sliding fee scale charges).

Expanding existing networks to work with state exchanges and secure new coverage options for patients.

Establishing quality measures to track achievement of outreach, engagement, and linkages to various coverage options.